ORIGINAL ARTICLE Oral Health Impact Profile in elderly Chileans in southern Chile. Matías Yobánolo-Hoffmann1. Abstract: Aim: To evaluate the impact of oral health on the quality of life Javiera Valentin-Hoyos1. of elderly patients (EP) in the public health system of Valdivia, Chile in 2015. Pedro Christian Aravena1,2. Methods: A descriptive study was conducted using the “Oral Health Impact Profile Spanish version” (OHIP-14Sp), in a population of 387 EP (71.8±7.5 years old; 53% women). The impact of oral health on the quality of life 1. Escuela de Odontología, Universidad was determined by the mean scale score that ranged beween 0 points (good Austral de Chile. Valdivia, Chile. quality of life) and 56 points (poor quality of life). In addition, oral health 2. Instituto de Anatomía, Histología y problems reported by EP population as having a greater influence on their Patología. Facultad de Medicina. Uni- versidad Austral de Chile. Valdivia, quality of life were also included in this study. Results: The mean score of Chile. OHIP-14Sp was 20.1±7.6 points. Items showing problems more frequently associated with quality of life were: “toothache” (32.8%), “appearance of the teeth” (32.8%), “sensitive teeth” (32.3%) and “difficulty for chewing food” (25.8%). Conclusion: The impact of oral health on the quality of life of the EP population was considered low when compared to the median score of OHIP-14Sp. Functional and aesthetic aspects showed the highest impact on Corresponding author: Pedro Christian Aravena. Rudloff 1640 Valdivia, Chile. the quality of life of EP in the city of Valdivia. Phone: (+56-63) 2221205 - Fax: (+56-63) Keywords: Quality of life, Oral health, OHIP-14, Elderly. 2293751. E-mail: [email protected] DOI: 10.17126/joralres.2015.071. Receipt: 09/17/2015 Revised: 10/01/2015 Cite as: Yobánolo-Hoffmann M, Valentin-Hoyos J & Aravena PC. Oral Health Impact Acceptance: 10/09/2015 Online: 10/09/2015 Profile in elderly Chileans in southern Chile. J Oral Res 2015; 4(6): 365-370. INTRODUCTION. The interest in evaluating diseases that affect quality The elderly population (EP) over 60 years of age has of life has been increasing gradually. To quantify quali- shown a progressive and rapid change in its population ty of life in relation to oral health, scales such as Oral pyramid. Globally, data from the United Nations predict Health Impact Profile- 49 (OHIP-49), Oral Health Impact that by 2050 one in five people will be over 60 years, es- Profile-14 (OHIP-14), Oral Impact of Daily Performance timating a rate higher than 24.1% in Chile, with a life (OIDP), Geriatric/General Oral Health Assessment Index expectancy of up to 80 years1. However, these figures are (GOHAI), among others4, have been used and validated. associated with dramatic oral health problems caused by In Chile, a group of researchers at Universidad de Tal- the loss of teeth in EP due to the lack of appropriate mea- ca validated the OHIP-14Sp scale in a group of Chilean sures to prevent and treat oral health problems throug- elders obtaining a high internal consistency (α=0.91)5. As hout their life2. a result, this instrument allows to quantify quality of life In 2003 less than 1% of the Chilean population over in relation to the perceived state of oral health in EP from 65 years old had all their teeth and a third of them was different regions of Chile. Local evidence suggests that EP totally toothless, demonstrating a perceived need for den- usually consider poor oral health condition as a normal tal prosthesis use in 55.3% of the EP, affecting various consequence of the aging process6. Thus, the analysis of aspects of their quality of life3. quality of life associated with oral health yield epidemio- 365 ISSN Online 0719-2479 - ©2015 - Official publication of the Facultad de Odontología, Universidad de Concepción - www.joralres.com Yobánolo-Hoffmann M, Valentin-Hoyos J & Aravena PC. Oral Health Impact Profile in elderly Chileans in southern Chile. J Oral Res 2015; 4(6): 365-370. DOI:10.17126/joralres.2015.071 logical data that can be compared with data from other tion, Physical pain, Psychological discomfort, Physical Latin American regions, facilitating the implementation disability, Psychological disability, Social disability, and of public health policies to improve the quality of life of Handicap) distributed in 14 items. Each item corresponds EP1. to oral health problems associated with quality of life and The aim of this study was to evaluate the impact of valued by frequency in a Likert scale of four points: “Ne- oral health on the quality of life of EP according to the ver” (0 points), “Almost never” (1 point), “Sometimes” (2 OHIP-14Sp scale in the public health system of the city of points), “Frequently” (3 points) and “Always” (4 points). Valdivia in southern Chile, 2015. The sum score of theOHIP-14Sp scale ranges between 0 points (good quality of life) and 56 points (poor quality MATERIALS AND METHODS. of life). Before using the scale, a validation face test was Study design conducted with a pilot study of 30 patients at the General A descriptive study of EP patients treated in the public Hospital of Valdivia. As a result, font size was increased health system of the city of Valdivia was performed in because most EP had difficulty reading the questionnaire. 2015. The research protocol was approved by the Research These participants were not included in the study sample. Ethics Committee of the Health Service of Valdivia (No. Two researchers (J.V.H; M.Y.H) applied the scale to 073/2015). patients in the waiting rooms of the services already men- Population and sample size tioned. The questionnaire was printed on a letter-size pa- The target population was EP patients over 60 years per using size 12 “Century Gothic”. Patients were briefly old who were regularly treated at the General Hospital explained the purpose of the questionnaire and asked to of Valdivia and at the Dr. Jorge Sabbath Family Health read and sign the informed consent. Then patients recei- Centre in the same city. A convenience sample was selec- ved the document along with an ink pen. They were gi- ted according to the number of EP patients who received ven a maximum of 20 minutes to answer the instrument. dental treatment at each health centre according to their Once completed, researchers gave the participating pa- scheduled appointments between March and June 2015. tients their contact information. The number of EP was established according to the sco- For each patient, the following independent variables re of the OHIP-14Sp scale presented by Leon et al.5, con- were registered: age (age range every 5 years), sex (male, sidering a standard deviation of 31.4 points, a confidence female), area of residence (urban, rural), smoking (yes, no) interval of 95% and a desired precision of 3.5 points; an and frequency of visits to the dentist for check-ups (one approximate number of 310 EP patients participated in or more visits per year, less than one visit per year). The the study (“EpiTools Epidemiological Calculators”. Aus- sum score of the OHIP-14Sp scale was registered as the tralian Biosecurity Cooperative Research Centre). dependent variable. EP patients selected were those who, after a verbal ex- Data analysis planation of the purpose of the study, accepted and ap- Surveys were coded in a Google Drive spreadsheet proved their participation by reading and signing the in- (Google Inc. Mountain View, CA, USA). The impact of formed consent. EP suffering from alcoholism, cognitive oral health on quality of life was assessed according to the impairment, illiterate or those who were dependent on average of the sum of scores obtained from each EP par- others were excluded from the study. ticipant. It was considered a low impact if the mean score “Oral Health Impact Profile” in Spanish (OHIP-14Sp) was lower than the median of the OHIP-14Sp scale (28 The OHIP-14Sp scale validated in Chile5 was used in points). In addition, those problems in which over 25% this study. This scale has 7 domains (Functional limita- of the EP selected the options “Frequently” and “Always” ISSN Online 0719-2479 - ©2015 - Official publication of the Facultad de Odontología, Universidad de Concepción - www.joralres.com 366 Yobánolo-Hoffmann M, Valentin-Hoyos J & Aravena PC. Oral Health Impact Profile in elderly Chileans in southern Chile. J Oral Res 2015; 4(6): 365-370. DOI:10.17126/joralres.2015.071 were highlighted. scale by chi square test and Student’s t test, respectively All values were calculated using descriptive statistics, (p<0.05), was calculated. Figures and tables were made in showing the mean score of the OHIP-14Sp scale. In addi- Microsoft Excel 2011 (Microsoft Corporation, Washing- tion, for each independent variable the proportion of ton, USA) and the analytical statistical analysis in STATA EP participants and the mean score of the OHIP-14Sp 10.0 (StataCorp, WA, USA). Table 1. Variables of patients and mean score of the OHIP-14Sp scale in elderly adults of the city of Valdivia, Chile. 2015. Variable Item Number of % p1 Mean score± SD p2 participants OHIP-14Sp Sex Female 205 52.9 20.3±7.8 .1 .18 Male 182 47.1 19.7±7.5 60-64 67 17.3 18.4±7.9 65-69 91 23.5 20.3±7.7 Age range (years) 70-74 89 23 .06 20.9±7.6 .1 75-79 66 17.1 20.3±7.1 ≥80 74 19.1 20.1±7.8 Area of residence Urban 316 81.6 <.001 20.3±7.4 .16 Rural 71 18.4 19.3±8.2 Smoker Yes 144 37.3 21.6±7.8 <.001 <.001 No 243 62.7 19.2±7.5 Frequency of visits One or more per year 102 26.4 <.001 17.2±7.6 <.001 to the dentist Less than once a year 285 73.6 21.1±7.7 1.